Home Login Corporate Profile Mission Statement Insurance Management Services and Products Automated Automobile Ins. Tracking Collateral Protection Ins. Flood/Wind Determination Guaranteed Asset Protection [GAP] Program Mortgage Fire Protection Mortgage Hazard Ins. Real Estate Appraisal Alternatives Vendors Single Interest Product Quotes Request a VSI Vendors Single Interest Quote Print A Blank GAP Application Fill out a GAP Application Contact SUI Test System

Product Quotes - Request a VSI Vendors Single Interest Quote Lender Name Mailing Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming   Zip  - Contact Title Phone -- Portfolio Information Please round all values to the nearest dollar Current Portfolio as of mm/dd/yyyy   Number of Loans Dollars Outstanding Automobile Additional Vehicles Boats, Motors, Trailers Recreational Land Vehicles Mobile Homes Percentage Direct Percentage Indirect Max Loan Term in Months Avg. Balance $ Avg. Loan Term in Months Experience Portfolio Y.T.D. Last Year Prior Year Avg. Over 30 Day Deliquency Ratio Number of Repos Avg. Deficiency Loss Per Repo Conversion/Confiscation Losses Other Carrier Experience Has single interest insurance been carried previously? Yes   No What optional coverages have been carried previously? Select as many as needed Non-Filing Conversion/Confiscation Repossessed Property Carrier's Name Current Carrier Experience   Y.T.D. Last Year Prior Year Rate Premiums Paid Losses Incurred Single Interest Non-Filing Conversion/Confiscation Repossessed Property Procedures Does the loan agreement require physical damage naming you as loss payee? Yes   No Do you verify insurance coverage before loan agreement is signed? Yes   No Do you make at least one follow-up for an insurance policy? Yes   No Do you follow-up with the customer in the event of cancellation or expiration of his policy? Yes   No Will you continue these procedures if you purchase this coverage? Yes   No Do you record your lien on the certificate of title? Yes   No Do you hold titles? Yes   No What are you filing procedures for non-titled collateral? Projected Growth - Number of New Loans   Last Year Y.T.D. Projected Next 12 Months Automobile Boats, Motors, Trailers Recreational Land Vehicles Mobile Homes Additional Vehicles Miscellaneous Will the existing portfolio be covered? Yes   No Will more than one state be involved? If yes, list states below. Yes   No Has any application for single interest coverage ever been declined, canceled or renewal refused? Yes   No Coverage Desired Automobile Yes   No Boats, Motors, Trailers Yes   No Recreational Vehicles Yes   No Mobile Homes Yes   No Additional Vehicles List Types Below Yes   No I wish a quote for... Physical Damage Yes   No Non-Filing Yes   No Conv/Confiscation Yes   No Repossessed Property Yes   No ACV Waiver Yes   No Per New Loan Yes   No Monthly Outstanding Balance Yes   No Comments Comments Lending Institution Officer E-mail address